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Severe itching and antihistamines

Hi all, I've been diagnosed with obstectric cholestasis - main symptom is severe itching. I've been put on Urso, which I take twice a day, plus piriton antihistamines up to 3 times a day (i'm taking them twice a day). I've only just started the antihistamines but have searched a couple of sites and found that some medics say you shouldn't use antihistamines for this condition. Has anyone else had cholestasis and been given piriton? Oh, I'm also on Vitamin K.

I had OC when I was pregnant with my DD. I wasn't given any medication (the hospital pharmacy had closed and I went into labour the day I was supposed to collect my meds) but was advised afterwards that I should have been told about piriton and I could take it. I actually started itching again last night, the palms of my hands are so itchy so I think it's made a return. If/when it's confirmed I will be taking piriton just to ease the symptoms a little, I was exhausted by the time I went into labour having only had about 10 hours sleep in the previous week made things a lot harder.

The vitamin K is because you are at higher risk of excessive blood loss, I didn't get the chance to have that either, I still only lost 200ml in labour which I don't think is very much at all.

Thanks, Polly Pocket. I'm sorry to hear that you may have OC again... but congrats on your pregnancy! That's good to hear that your hospital recommended piriton too. I was quite worried. I think the jury is out as to whether the urso helps but some researchers think it helps both the mother and the baby by neutralising the bile acid (I think that's right anyway). I'm 33 weeks with twins. I'll be having them around 37/38 weeks (if not before!). I was told that if it was one baby they'd induce me around this time to avoid complications for the baby.

I had OC with my DS and took Piriton once a day from 35wks. I found it made me quite drowsy so chose to manage my symptoms myself during the day but I took a Piriton in the evening (when it tended to be worse) and it helped me get through the night.

I was also prescribed Urso and took that from 38wks and ended up getting induced at 39wks, but that was mainly due to having developed pre-eclampsia rather than the OC. I was, however, told I would be induced at term had I not developed the pre-eclampsia.

I'm sorry you have OC, it really isn't very nice. Are you having your bloods monitored regularly? I ended up with liver and gall bladder scans and weekly bloods just to keep an eye on things but DS was absolutely unaffected!

Hi Polly Pocket and Simmmo, it's good to know your babies were unaffected by the condition. I'm having blood tests every week now and have to go to the hospital every other week to check the babies' movement etc. I'm glad to hear that urso and piriton seem to be standard treatments here. I was a bit freaked out when I saw the American sites that said you shouldn't be on piriton with OC. I'm trying to keep my dose down to twice a day with the piriton. I'm still itching quite a bit but I think it may be a little better. Keeping the house quite cool also seems to help a bit. PP, is there a link between premature birth and OC? Thanks again! Cathy xxxx

That's good to know re. you going full term! They want to induce me at 38 weeks and I'm wondering if this might be a little late given that OC is most risky to the babies in the last few weeks. From what I've read babies are usually induced at 37-38 weeks so I wonder if 37 weeks would be safer option? Cathy xxx

I would have thought with you having twins they would like to induce nearer 37 weeks than 38. Are you seeing a consultant about your OC? When I spoke to my consultant when I was 20 weeks I was told that they only induce between 37-38 weeks if the bile salt level was above 40, last time my bile salt level was 84.5 so well above the level they induce at in the hospital I'm at just my DD decided she was ready before they booked me in. I think it does vary depending on the general opinion of the hospital you're attending, so if I were you I'd definitely ask and tell them your concerns.

Thanks PP. I haven't yet seen the twin specialist at my hosp - something I'm going to ask to do. I need to check with him whether it will be 37 or 38 weeks. I think I'd be more comfortable with 37 given the risks late in pregnancy with OC. Cathy xxx

Hi PP, I'm sorry to hear you've got OC again! I hope they'll be able to give you something to relieve the itching. I'm feeling a bit better because, I think, of the piriton, but I'm only taking it twice a day instead of 3 times to try and minimize the amount of drugs I'm on. I had a blood test today and will have a hospital appointment next week to discuss the results. Good luck with your apppointment! Let me know how you get on. Cathy xxx

It's good to hear your itching has eased a little and I really hope that means your levels are on the way down and it's not just the piriton. I was told about a menthol aqueous cream (I don't know the name of it) that is supposed to ease the itching also, next time I'm in town I'll ask the pharmacist if they know what it is.

The upshot of my appointment is my levels are really quiet high, ALT's 954 and bile acids 68.6. I've been put on Urso which I have to pick up tonight because they didn't have it this morning, I can take piriton, I've been booked in for a liver scan on Monday and I'm seeing my consultant a week tomorrow.

Hi PP, I'm sorry your levels are raised. I hope the urso and the piriton will help. It took about 3-4 days for mine to kick in, I think. I'm still getting pretty itchy, but I'd say there's a definite improvement. I've found it helps if I don't keep the house quite as warm as I'd like . I've been given a perscription for the menthol ointment and have also been given some calamine, but I haven't used the calamine because it's quite messy and in my experience only soothes whilst it's drying.

Good luck with your liver scan! Let me know how you get on. I find out early next week if anything has changed. Cathy xxx

I'm so glad the meds are working for you, I'll be interested to hear if your levels are now lower. You are definitely right being cooler does help with the itching, every time I visit the hospital it flares up again because they keep it so hot in there! I'm not too bad at home, I honestly thought I'd be itching more as I was when I had it last time.

Hi everyone, can you tell me, those who've had or who have OC, when you were told to stop taking the vitamin K? I've been told different things by different doctors at my hospital. I'm having twins and will have them at 38 weeks (if not before). I've been told by one doc I need to stop the vit K at 36 weeks; a second doc says you START the vit K 4 weeks before you have the babies and take it right up to the birth. I'm a bit confused! Thanks!

Hi Polly Pocket, sorry to hear your itching is worse! Good news that the levels are down. That's a great idea re. asking about Vitamin K. I'll give it a try. I asked about my levels and they said they don't do the bile acid test again and the doctor I saw didn't have the older results for the liver function test to compare. So I still don't know if they're up or down! After taking the Urso for a few weeks now plus the piriton I am feeling less itchy, which is a big relief. Also less tired and less nauseous, but that may be because I've pretty much finished work now. Part of the reason my levels for OC got forgotten was that I had a suspected DVT (clot) but it turned out to be nothing after a scan of my leg. My legs have been swelling a lot and last night my foot ballooned and was hot and red, so I was all ready to phone the hospital again!

I hope the drugs kick in properly for you soon and that you do stop itchy. It's maddening, isn't it?! Cathy xxx

Your bile acid and LFT's should be done weekly, bile acids are the ones that it's believed to cause the most problems so it is so important that it is checked regularly. I really think you should chase it up, could your MW get all your results for you? Mine phones up if needs be and gets my latest results.

I hope your foot goes down, that can't be nice. I wonder what it is causing it?

I saw the consultant today, LO is breech but will hopefully turn in time if not I won't have many options! Unless I go into labour naturally I'll be induced at about 38 weeks unless my levels go up or things change. I'm having blood test done weekly until LO arrives or I'm induced and I have to go to the day unit to have it done so they'll be looking after me and monitoring me at least once a week, more so if I have reduced movements of any concerns. I'm back at the consultants in 3 weeks to discuss it all and make more plans, or course that could all go out the window if LO decides he/she is ready to arrive sooner!

I'm glad your itching is better and I hope you are well. Let me know how you are!

Hi Polly Pocket, my itching is quite a bit better at the moment. What about you? It took the urso a good few days to kick in, I think. Thanks for the info re the bile acid tests. The registrar I saw last week said they don't do the bile test again, so I'm definitely going to query this. I am supposed to be having weekly liver function tests but didn't have one this week. I mentioned this to the community MW and she said to have one when I'm next at the hospital, which is Monday. I need to make sure they're keeping a proper check on all of this. I'm going to have the c-section at 38 weeks and will press for a date tomorrow when I see the registrar. I've read somewhere that induction doesn't always work with twins and I think I'm more comfortable with the idea of a section.

I hope you're starting to feel a bit better. I know the OC has been driving me nuts and it started very early - at about 22 weeks.

They really should be keeping a better eye on you! My consultant said I am to be seen weekly by the day unit for bloods including LFT, bile acid and I think they test my Hb every time too. You should be getting the same to make sure your levels are not rising and the urso is doing what it should. Btw, I had a few problems with everyone thinking someone else should be taking my bloods weekly, with the day unit they are used to seeing the results and know the best way to respond if there is any change which is why my cons wanted me to have it done with the day unit.

I think you need to do what is best for you, if you would prefer a c-section then go for it. I hope you get a date soon.

My itching is better than it was, I'm still itchy but it's not as bad at night and I can sleep a lot better than I could.

Hi Polly Pocket, what a relief that the itching is a bit better! I'm really glad to hear that. Yes, I was concerned that having been told I'd been seen every week once the diagnosis had been made for OC that suddenly I was told I wouldn't be seen for the last 3 weeks! I also was concerned that one of the twins is now smaller than the other and has only a third of the amniotic fluid. The hosp said they weren't too worried about this, but it did seem odd that they weren't going to monitor it. The twins are non-identical so it's not twin-to-twin transfusion. Anyway, I phoned the hospital and asked to see the twin specialist. The hospital said that though they're not too worried about the fluid they have made an appointment for me for next week to see the specialist, so I'm very relieved. I don't want to rely on keeping track of the babies' movements to know that everything is OK. For the OC they were doing CGTs every time I went in, but not this week. I will ask if I should be having these too. I've got a date now for the c-section! Getting excited but also worrying that everything is going to be OK.

I hope your itching continues to lessen and that you start feeling a lot better. Cathy xxx

I can see why you're worried, having a baby or two in your case is worrying enough without added complications like OC. The care you receive is paramount in how you feel about the whole thing and feeling like you're being left must be awful. I am glad you are being seen next week and I hope that they check you out as often as you feel you need to be.

I'm glad you've got a date for your c-section too!

I saw my MW yesterday and my baby was head down and 3/5 engaged she did say that it may well turn breech again as second babies often have more room to move but I am feeling a lot better about it all than I was.

Hi Polly Pocket, that's great news that your baby is head down ! My little girl has flipped and is now breech, but this won't affect me because of having a c-section. I've been in touch with the hospital who say they're not really concerned about the amniotic fluid, but from what I've read on line it's the little girl who has too much fluid, not the boy with too little. She would be classed as mild polyhydramnios. I'm glad I'm seeing the specialist next week anyway to discuss this properly. In its mild form, it not supposed to be too much cause for concern but the level has started rising in the last few weeks, since my last scan at 32 weeks. Will be so glad when the babies are finally here! How's your itching? Is it any better?

Just popping in briefly here.. I also had OC with my twins.. I didn't get the URSO or Vit K until a day or two before my waters broke at 34+5.. I was monitored for weeks.. but they seemed reluctant to give the URSO, despite Simmo having no problem with it and we were at the same hospital.. I stayed away from Prition only because I could cope with the itching.. mine was worse on my back.. and a good rub seemed to alleviate it briefly.. but would have taken it if it had got unbearable..I can't remember where my levels got to in the end, something like 700.. but they did come down again afterwards.. just make sure they are looking after you.. they said to me there was a point that if my levels reached, the babies would be delivered, but I could never get an answer as to what that level was..

Hope itching eases for you both soon.. as PP will know, it disappears almost instantly once babies are born.. (PP - sorry to hear you have OC again)

Thanks, Bouncytigger. I wonder if I should try to stop the piriton? The itching IS a lot better now. I take two a day and have been told I could take 3 if I wanted. Congrats on your twins! Great news I hope that PP's itching eases soon. Horrible to have it twice! Cathy xxx

I know what you mean for it to be a relief when your babies arrive, I remember being so glad to hold Nancy after she was born and I knew she was well. It's good you're being seen next week, I hope you get more reassurance. Piriton won't do any harm, continue to take it if it works for you. I find it zonks me out too much but have taken it occasionally, I can sleep for England on just one tablet which isn't very helpful when you've got a toddler that is full of beans to look after.

BT, I'm glad you and your babies are well. It is strange how quickly the itching stops after you've delivered isn't it? I'm glad your levels are back down again.

My itching is still there but is no where near as bad as it was a couple of weeks ago. I feel like I've got off lightly this time, my itching was terrible when I was pg with Nancy, I could sleep an hour may two at the most without being woken up by it. I slept 5 hours in one go last night, I have trouble doing that normally!